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Review
. 2022 Sep;5(9):e1626.
doi: 10.1002/cnr2.1626. Epub 2022 May 18.

Total calcaneal allograft reconstruction of an Ewing's sarcoma in a child: Outcome and review of the literature

Affiliations
Review

Total calcaneal allograft reconstruction of an Ewing's sarcoma in a child: Outcome and review of the literature

Ferran Torner et al. Cancer Rep (Hoboken). 2022 Sep.

Abstract

Background: Ewing's sarcoma rarely presents in bones of the feet. Surgical management usually includes amputation. Limb sparing surgery is anecdotal.

Case: We report the case of a 13-year-old boy with an Ewing sarcoma in his calcaneus who had a calcaneal reconstruction with total calcaneus allograft after induction chemotherapy.

Conclusions: At 42 months of follow-up our patient remains disease free and functionally intact. A review of the exceptional limb salvage procedure options for malignant calcaneus tumor was performed.

Keywords: Ewing's sarcoma; limb salvage surgery; allograft; calcaneus; tumor.

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Conflict of interest statement

The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Figures

FIGURE 1
FIGURE 1
Magnetic resonance imaging with a calcaneus bone lesion with soft tissue component, very vascular, that breaks the bone cortex, with necrosis focus inside. (A) Coronal view. (B) Sagittal view
FIGURE 2
FIGURE 2
(A) Lateral calcaneus approach extended with a posterior ankle approach. (B) Dissection of the soft tissues. (C) Calcaneus resected in bloc. (D) Talocalcaneal and calcaneocuboid arthrodesis
FIGURE 3
FIGURE 3
(A) Nests of tumor cells in a fibrous tissue background (Hematoxylin and Eosin [H & E], power of magnification 200×). (B) Tumoral cells of Ewing sarcoma showing membranous expression of CD99 (power of magnification 200×). Nest of tumoral small round cells (H & E; power of magnification 200×)
FIGURE 4
FIGURE 4
(A) X‐ray at 42 months of follow‐up showed an allograft calcaneus and screws in stable position, with arthrodesis healed successfully, especially at talocalcaneal joint. (B) Wound healing at final follow up. (C) Dorsiflexion of the ankle. (D) Plantar flexion of the ankle

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